Individual provider Active NPI

Jesus Rene Guerra, FNP

  • Family Nurse Practitioner
  • Weslaco, TX
National Provider Identifier
1558610477
Registry record updated Sep 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
617448 Issued in TX
Practice address
906 S. Bridge Ave.
Weslaco, TX 78596
Phone
(956) 447-8600
Fax
(956) 447-0335
NPI assigned
Sep 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 617448 TX Primary

Addresses

Primary practice location

906 S. Bridge Ave.
Weslaco, TX 78596

Mailing address

1259 Chloe Rae Circle
Weslaco, TX 78596
Phone (956) 447-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171114003000 TX Practitioner - Nurse Practitioner 5799060372 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
617448TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pedro J. Penalo, M.D., PLLC CurrentSince May 27, 2017 Accepting new patients

Locations

330 N Ohio Ave
Mercedes, TX 78570
Phone (956) 565-1561

906 S Bridge Ave
Weslaco, TX 78596
Phone (956) 447-8600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1558610477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1259 CHLOE RAE CIRCLE",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "78596",
            "telephone_number": "956-447-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 S. BRIDGE AVE.",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "78596",
            "telephone_number": "956-447-8600",
            "fax_number": "956-447-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRA",
        "first_name": "JESUS",
        "middle_name": "RENE",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-06",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "617448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weslaco, TX

Sources for this page

Verify at the official NPI Registry.